Emollients, urea-containing

How it works

Urea acts as a humectant that binds water in the stratum corneum and has keratolytic properties that soften and reduce thickened, scaly skin.

Prescribing in practice

• Urea can cause transient stinging or burning, particularly on fissured, inflamed or broken skin, so warn patients and avoid application to acutely inflamed areas.
• They are particularly useful where additional softening of thickened or scaly skin is needed beyond a plain emollient.
• Some products combine urea with other agents such as lactic acid; check the full formulation for additional cautions.

Monitoring

No laboratory monitoring is required; review skin condition, tolerability and any stinging on application.

Counselling the patient

• A brief stinging sensation may occur, especially on cracked skin, and usually settles with continued use.
• Apply regularly to keep the skin hydrated and softened.
• Avoid the eyes and apply to clean skin, ideally after washing.

Evidence & guidelines

Urea-containing emollients are well-established in dermatological practice for dry and hyperkeratotic skin, consistent with NICE emollient-based management of eczema.